Lung cancer: key points

• In Scotland, after non-melanoma skin cancer and prostate cancer, lung cancer is the third most commonly diagnosed cancer in men. It is the third most commonly diagnosed cancer in women after non-melanoma skin cancer and breast cancer. It is the most common cause of death from cancer in both men and women.
• Survival from lung cancer is poor with less than 10% of patients still alive at five years after diagnosis.
• Currently, around 2500 men and 2160 women are diagnosed with lung cancer in Scotland every year.
• Excluding non-melanoma skin cancer, lung cancer accounts for 19% of all cancers diagnosed in men, and just over 15% of all cancers diagnosed in women.
• Based on current rates of disease, an estimated 1 in 11 men, and 1 in 17 women develop lung cancer during their lifetime.
• Between 1994 and 2004, the age-standardised incidence rate of lung cancer decreased by an estimated 25% in men, but increased by 5.6% in women.
• Historically, Scotland has had one of the highest rates of lung cancer in the world. However, mortality rates among men are now higher in some Eastern European countries, and rates in Danish women are approaching those in Scottish women.
• Tobacco smoking is the main risk factor for lung cancer, accounting for an estimated 80-90% of cases in developed countries. Other risk factors include asbestos, ionising radiation (including domestic exposure to radon), and various chemicals usually encountered in occupational settings.
• Per cigarette smoked, the risk of lung cancer seems to be higher in the west of Scotland than in some other populations, perhaps reflecting the additional effect of past occupational exposures, or other factors such as nutrition.
• The cumulative risk of lung cancer can be reduced by around 90% in smokers who manage to quit before middle age. Thus smoking cessation policies and services play a major part in the primary prevention of lung cancer.
• Several randomized trials of screening by chest x-ray and sputum cytology did not demonstrate a reduction in mortality from lung cancer. The advent of low-dose spiral CT scanning has re-awakened interest in screening for lung cancer, and several trials are underway in different countries (USA, The Netherlands and France).
• The risk of developing lung cancer is higher, and the probability of surviving lung cancer is lower among people living in areas of socioeconomic deprivation.
• Previous audits and international comparisons have suggested possible scope for improving outcomes from lung cancer in Scotland, and there is some recent evidence that a higher proportion of patients with lung cancer are now receiving potentially curative therapy in the context of disease management by multi-disciplinary teams.

Key Statistics:

	Males	Females
Number of cases diagnosed in 2004	2,506	2,160
Prevalence at 31st Dec 2003 (cases / 100,000 pop) (1)	128	101
Number of deaths in 2005	2,195	1,814
% surviving 5 years after diagnosis (2)	6.8%	7.8%
Lifetime risk of developing lung cancer (from birth)	7.8%	5.5%
Lifetime risk of developing lung cancer (from age 54)	8.3%	5.5%

Notes:
(1) Number of lung cancer survivors at 31 Dec 2003 who had been diagnosed in the previous 20 years per 100,000 population.
(2) Five year relative survival for patients diagnosed during the period 1997-2001 (not standardised).